My brother in law works with the CDC and Sanjay Gupta @ Emory and my cousin works in infectous disease @ Stanford.
If you want REAL info first hand and not the BULLSHIT the media is feeding you let me know and I will post updates.
Do you have any updates to post ? The more information we can get the better. Most of us have elderly parents/grandparents. It's best to be prepared for the worse and hope for the best.(imho)
Dr. Mohamed Abu-Abed,
Medical Director - Brampton Civic Hospital
The coronavirus for most people is more like a bad cold ~80% of the time. However for those that get very sick survival is completely based on availability of ICU level care. Northern Italy continues to see a rise in deaths as they have maxed out capacity. To understand, Lombardy is the wealthiest part of Italy and it is one of the wealthiest regions in the EU. In Ontario, we have an average of 2 hospital beds per 1000 people. In Italy they have 3.18 hospital beds per 1000 people; that is 59% more capacity.
In those that get sick 10% of the time they will require ICU level care. They will require life support machines (ventilators). In Italy they have so many sick that there are no ventilators left to use. The lock down in the country was called when their health care system began to collapse. People are dying because there is literally no way to treat them. Italian guidelines now specify that if you are 60 or older and get sick requiring ICU level care, you will not even be considered for a ventilator, as priority is given to the young who have a better chance at living; if and when a ventilator becomes available. The usual length of time someone is on a ventilator is 2 to 8 weeks, before they either die or recover. Turn around is very slow. To repeat they have maxed out their ICU capacity. Doctors are now deciding who to place on respirators and who will be allowed to die. There are no respirators, the old and sick are allowed to die. If you get sick from anything else, appendix ruptures, car accident, heart attack, etc and need ICU level care, you will likely die. There is no capacity left! 10% of their health care workers are unable to work due to the illness.
Italy went from 153 cases on February 23rd to 7375 cases on March 7th, when the decision to shut down Lombardy was made. In those 13days the country decided to wait and see, only to learn now that it was a grievous mistake. Even after the shutdown of the entire country the case numbers are growing tremendously and will continue to do so with a shattered health care system. There will be thousands more in deaths. Because of the saturation of the health care system the mortality rate is at 6.7% right now. In a Country such as South Korea that has enacted strict and decisive measures, they also have the luxury of 13 beds per 1000 people, or 6.5 times the capacity of Ontario, they only have a 0.8% mortality rate. Do not fool yourself; Canada will have bigger problems than Italy with higher death rates as we will saturate our ICUs quicker. To repeat we have 2 hospital beds per 1000 people, Italy has 3.18 per 1000 and South Korea has 13 per 1000.
Canada reported 158 cases today (Almost exactly where Italy was 13 days before they shut down Lombardy). COVID has been slowly rising in Canada and initially felt to be under control and related to travel, in the last 24 hours the numbers related to US travel has significantly grown. It is exceptionally clear that the US numbers are only low because they do NOT have access to test kits. In New York, Governor Cuomo announced today that they will not have adequate test kits until sometime next week. Washington State is also seeing a major backlog. In the medical community it is felt that in those two clusters we likely have well over 10,000 cases in each cluster. In an interview today with Governor Cuomo, New York is expecting to be in the same situation as Italy and Wuhan in the coming week.
In no uncertain terms with an open and free border between the US and Canada we are on a path to a larger disaster than Italy. In this next week, we will likely enter a point of no return and when that happens there will be mass casualties and the economic impact of those loses will be felt and remembered as a failure of our administrations to act.
It takes courage to make bold decisions I do not envy the position you are in. As a father, as a son, as a physician who will see thousands die needlessly I implore you to enact a countrywide quarantine/shut down. With March break approaching 1000s will be infected and every day we delay is thousands more deaths. There is a point of no return coming. Wuhan has seen it, Italy has seen it, Spain is likely going to see it, New York and Washington State will see it. Canada has hope but we need to act NOW.
Please contact me if you have any questions. As a physician working at one of the busiest hospitals in the Country for almost a decade I can without a doubt advise there is minimal capacity to absorb the shock of the increased health care load that is coming. When our health care system saturates; as did Italy?s we will see mass needless loss.
